PAHO/WHO member countries have made major progress in implementing the Framework Convention on Tobacco Control (FCTC), the world's first international health treaty, which went into force a decade ago

Washington, D.C., 26 February 2015 (PAHO/WHO) — Despite fierce opposition from the tobacco industry, a number of countries in the Americas have made major progress in implementing the Framework Convention on Tobacco Control (FCTC). This week marks a decade since the agreement took effect as the world's first international health treaty.

WHO Framework Convention on Tobacco Control infographic"Ten years ago, establishing smoke-free environments, requiring graphic warnings on tobacco packages, banning tobacco advertising, promotion and sponsorship, and increasing tobacco taxes all seemed like a pipe dream," said Dr. Carissa F. Etienne, Director of the Pan American Health Organization/World Health Organization (PAHO/WHO). "Now it's a reality. Tobacco—one of the world's deadliest consumer products—has been exposed, and the 10th anniversary of that feat marks a true public health milestone."

Tobacco is the only legal consumer product that kills up to half of those who use it as intended by the manufacturer. Worldwide, it kills one person every six seconds. Tobacco use is a risk factor for six of the eight leading causes of death worldwide and a shared risk factor for all four of the most common noncommunicable diseases: cardiovascular disease, cancer, chronic respiratory disease and diabetes.

To counter the devastating impact of the global tobacco epidemic, WHO member countries adopted the FCTC at the World Health Assembly in 2003, and it went into force on 27 February 2005. A legally binding agreement, it sets forth a series of measures to reduce tobacco demand and supply, ranging from increased taxes on cigarettes and smoke-free public spaces to mandatory graphic health warnings and bans on tobacco advertising, promotion and sponsorship.

Full implementation of the agreement would lead to an estimated 30% reduction in the prevalence of tobacco use in people aged 15 and over and would contribute substantially to the global target of reducing premature deaths from noncommunicable diseases by 25% by 2025.

FCTC progress in the Americas

In the Americas, 30 of 35 countries have to date ratified the FCTC. Regional progress in implementing the treaty's provisions includes:

  • 17 countries in the Americas have passed laws banning smoking in indoor workplaces and public places—a measure that protects nonsmokers from secondhand smoke and also helps smokers to quit.
  • 17 countries require tobacco packaging to display large graphic health warnings that show the harmful health effects of tobacco use.
  • Six countries in the region have banned all forms of tobacco advertising, promotion and sponsorship.
  • Countries including Brazil, Chile, Costa Rica, Ecuador, Grenada, Mexico, Panama, St. Lucia, Suriname, Uruguay and Venezuela have increased taxes on tobacco, reducing the affordability of tobacco products. Costa Rica and Panama are using the extra revenues to fund health programs.
  • Five countries—Brazil, Canada, Chile, Panama and Uruguay—are on track toward full implementation of the FCTC, having implemented the majority of a package of six most-effective measures to reduce tobacco use (MPOWER), identified by WHO to help countries fulfill their commitments under the FCTC.

Much of this progress in the Americas has been achieved despite active opposition from the tobacco industry, which has sought to halt, delay or dilute FCTC implementation by lobbying lawmakers and especially through litigation.

Tobacco maker Philip Morris is fighting Uruguayan regulations that require health warnings to cover 80% of the main surface of tobacco packages and that limit manufacturers to one unique presentation per cigarette brand. Alleging that these measures violate the company's trade rights, Philip Morris took its claim to the World Bank's International Centre for Settlement of Investment Disputes. PAHO/WHO has supported Uruguay's defense of the measures, noting that they are aimed at saving lives and serve as model actions for other countries in the Americas and worldwide.

"We know that reducing tobacco use saves lives, but we also know that industry will not sit back quietly and let it happen," said Adriana Blanco, PAHO/WHO senior advisor on tobacco control. "The 10th anniversary of the FCTC is a good time to take stock of our progress so far and to inspire all countries to join together in making the tobacco epidemic a thing of the past."

As part of the FCTC process, a new Protocol to Eliminate Illicit Trade in Tobacco Products was adopted by WHO member countries in 2012 to address the problem of the illicit tobacco trade, which accounts for one in every 10 cigarettes as well as many other tobacco products.

"I am calling on our Member States in the Americas to follow the lead of Nicaragua and Uruguay and become parties to this protocol," said PAHO/WHO Director Etienne. "Our region can help generate the 40 ratifications needed for the protocol to enter into force."


PAHO, founded in 1902, is the oldest international public health organization in the world. It works with its member countries to improve the health and the quality of life of the people of the Americas. It also serves as the Regional Office for the Americas of WHO.


MPOWER is a set of six priority tobacco control measures identified by WHO to help countries achieve compliance with their obligations under the Framework Convention on Tobacco Control (FCTC).

MPOWER's six components are:

  1. Monitor tobacco use and prevention policies
  2. Protect people from tobacco smoke
  3. Offer help to quit tobacco use
  4. Warn about the dangers of tobacco
  5. Enforce bans on tobacco advertising, promotion and sponsorship
  6. Raise taxes on tobacco